Infertility is defined as a lack of pregnancy despite >1 year of unprotected sexual intercourse, and its prevalence is rising.^1,2 There are many factors that affect fertility, but growing research indicates that modifiable factors such as weight, lifestyle, and dietary patterns can significantly affect fertility.² Diets that promote weight loss, such as the ketogenic diet, has the potential to improve fertility.

Does the Ketogenic Diet Improve Fertility? 

The ketogenic diet is a diet that focuses on the consumption of very low amounts of carbohydrate, very high amounts of fat, and moderate amounts of protein.³ It has gained increasing popularity due to its effectiveness in promoting weight loss and improving metabolic profiles.^4,5 

Currently, large studies on the effects of ketogenic diet on fertility are limited. However, research is beginning to show that the diet may have favorable effects on fertility outcomes. For instance, a systematic review analyzed seven studies on the effects of low carbohydrate diets in overweight and obese women and concluded that the diet was associated with improved balance in sex hormones and reduced fasting insulin levels.⁶ Improved rates of ovulation, menstrual cyclicity, and pregnancy were also observed. It is hypothesized that weight loss achieved with the ketogenic diet is associated with improvements in polycystic ovarian syndrome (PCOS), known as one of the biggest culprits of infertility.^7–9 Studies show that the diet can improve sex hormone and lipid levels, and normalize ovulation-menstruation cycle in women with PCOS, thereby improving fertility in this population.⁷ However, more research is needed to show that the ketogenic diet can improve non-PCOS related infertility.⁶ Additionally, there is a lack of human research studying how the ketogenic diet affects male fertility. However, mice studies begin to show that introducing a ketogenic diet in obese mice model can enhance spermatogenesis (ie, sperm production), sperm quality, and increase testosterone levels by improving metabolic parameters.^10,11

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